Difficulties in Functioning 1 Year After Injury: The Role of Preinjury Sociodemographic and Health Characteristics, Health Care and Injury-Related Factors

Abstract

ObjectiveTo identify the role of preinjury sociodemographic and health characteristics, injury and injury-related health care characteristics in determining functional outcomes 12 months after injury. DesignProspective cohort study involving 1-year follow-up. SettingCommunity. ParticipantsStudy participants (N=2282; age range, 18–64y inclusive) were those in the Prospective Outcomes of Injury Study who completed the 12-month interview. The original cohort of 2856 were injured and registered with New Zealand's national no-fault injury insurance agency. With the exception of injury and hospitalization, information on predictors and outcomes was obtained directly from the participants, primarily by telephone interviews, approximately 3 and 12 months after their injury. InterventionsNot applicable. Main Outcome MeasuresThe functional outcomes of interest were the 5 dimensions of the EQ-5D plus a cognitive dimension. Our multivariate analyses included adjustment for preinjury EQ-5D status and time between injury and the 12-month interview. ResultsSubstantial portions of participants continued to have adverse outcomes, especially pain/discomfort, 12 months after their injury. The significance of factors varied by outcome. Factors adversely associated with at least 3 of the 6 outcomes were preinjury EQ-5D status, being female, aged 45 to 64 years, inadequate household income, preinjury disability, 2 or more prior chronic illnesses, smoking regularly, dislocation or sprains to the spine or upper extremities, and having a relatively severe injury. ConclusionsA range of preinjury sociodemographic and health characteristics are associated with several adverse functional outcomes 1 year after injury, independent of the nature and severity of injury. The latter, however, also have independent effects on the outcomes.